"I am but mad north-north-west: when the wind is southerly I know a hawk from a handsaw." --Hamlet, Act II, scene ii.

Saturday, 16 January 2010

Medical Hypotheses row resurfaces

Last year, publishers Elsevier got into trouble with HIV-AIDS researchers, after Medical Hypotheses (an Elsevier journal) published two papers on the subject of AIDS: one by Peter Duesberg claiming that the AIDS epidemic in South Africa was overhyped, and another by Marco Ruggiero suggesting that the Italian health ministry did not believe that HIV was the sole cause of AIDS (blog posts at Bad Science and Respectful Insolence). The papers were deeply flawed, and were retracted by Elsevier pending an investigation into how they were published. The story has now resurfaced in the Times Higher Education Supplement (THES), because:

Prominent Aids researchers contacted Elsevier to object to the article and wrote to the US National Library of Medicine requesting that Medical Hypotheses be removed from the Medline citation database - an act that would exclude it from the mainstream scientific-communication network.

Elsevier have now convened an expert panel to decide on the future of Medical Hypotheses, with conclusions due by the end of 2010.

In fact, there is no great mystery as to how these flawed papers came to be published. Medical Hypotheses is not peer reviewed: instead, decisions on publication are taken solely by the journal's editor, Prof Bruce Charlton. Articles are often accepted within days, or even hours, of being submitted, suggesting there is little or no quality control on what gets published. Prof Charlton defends this process on two grounds: firstly, that there ought to be some outlet for speculative and bizarre ideas that will not be published by mainstream journals. Secondly, that Medical Hypotheses is a successful and influential journal. Here's what he has to say on the comments following the THES article:

The basic facts are that Medical Hypotheses - www.elsevier.com/locate/mehy - is explicitly and proudly editorially-reviewed (i.e. by me - not peer reviewed); aims to publish radical and revolutionary scientific ideas; and it is objectively a successful journal. It makes a profit, the Thomson ISI Impact Factor is 1.416 (much better than average, and rising), and I know from internal sources that there are half a million papers downloaded per year - which is equivalent download usage to the prestigious Journal of Theoretical Biology. Clearly, in spite or because of our policy to publish bold and sometimes bizarre ideas, Medical Hypotheses plays a significant role in medical science. Fact; not opinion. The editorial advisory board currently includes such respected figures as Nobelist Arvid Carlsson http://en.wikipedia.org/wiki/Arvid_Carlsson; Sir Roy Calne http://en.wikipedia.org/wiki/Roy_Calne; Antonio Damasio http://en.wikipedia.org/wiki/Antonio_Damasio and V.S. Ramachandran http://en.wikipedia.org/wiki/Vilayanur_S._Ramachandran . Past editorial advisors have included Sir Karl Popper and Nobelist Sir James Black. *** There are only two possible legitimate outcomes to the current process. Either: 1. Medical Hypotheses could continue as an influential, profitable and well-known editorially-reviewed journal with a radical mission. Or else: 2. The journal could be closed-down altogether, and the title abolished. But it would obviously not be ethically acceptable to launch a new ‘imposter’ journal - with utterly different editorial aims, procedures and personnel; yet retaining the 34 year established title of Medical Hypotheses.

As I keep saying, the impact factor of a journal tells you nothing about its quality. For example, here are three peer-reviewed pseudojournals that repeatedly publish abject nonsense and pdeudoscience, with their impact factors according to Journal Citation Reports:

Homeopathy: 1.041

Evidence-based Complementary and Alternative Medicine: 1.954

Journal of Alternative and Complementary Medicine: 1.628

The articles in these journals are typically written by quacks, and are cited by other quacks writing in quack journals, giving a high-ish but meaningless impact factor. Perhaps Medical Hypotheses is also highly influential among pseudoscientists?

But the main point here is about radical and controversial hypotheses. I think most people would agree that these have their place in scientific discourse, and there ought to be somewhere to publish them. However, this isn't really what the argument is about. In this case, two fatally flawed papers were published with little or no scrutiny: these papers have potential global health implications. In the case of the Duesberg paper, reviews posted on the Denying AIDS blog show the major problems with the paper. There's a difference between publishing provocative ideas that might inspire new research, and ones that are just demonstrably wrong. While the likes of Peter Duesberg have the right to say what they like, they don't have the right to say it in a MEDLINE-indexed journal. This is not an argument about free speech, it's an argument about the integrity of the scientific literature. There may be a place for journals such as Medical Hypotheses, but there has to be some level of quality control. Otherwise, why should anyone take them seriously?

5 comments:

Seth Kalichman
said...

Thanks for the thought provoking post. Med Hypotheses had given AIDS denialists a means for claiming credibility. While the Editor may understand the mission of his journal not everyone who searches medline does. That is why we had to complain to Elsevier. I have posted extensively on this story on my blog http://denyingaids.blogspot.com

I also discuss Duesberg at great length (he has his own chapter) in my new book Denying AIDS: Conspiracy Theories, Pseudoscience, and Human Tragedy (all royalties are used to buy HIV medications in Africa).Thanks again for an interesting perspective. Seth Kalichmanhttp://denyingaids.blogspot.com

Thanks for the comments...as you say, the papers have given AIDS denialists some credibility. If you're going to do this, you want to be pretty sure that the papers are solid. But the papers appear to have had no substantial scrutiny at all before being published.

Unfortunately, if Elsevier dumps Medical Hypotheses, the AIDS denialist and other cranks, quacks and loons will use that as further evidence that "entrenched mainstream science" is trying to suppress the "brave maverick scientists". Perhaps the best thing would be to de-list it from MedLine (along with Homeopathy and Journal of Alternative and Complementary Medicine).

I periodically have students who stumble across Medical Hypotheses and mistake it for a real journal - there seems to be a real bias toward believing anything seen in print. For that reason, we need some way for people to know that journals like Medical Hypotheses are no more fact-based than National Enquirer.

"Thanks for the comments...as you say, the papers have given AIDS denialists some credibility."

Credibility with who, though? Speaking for myself if I see a paper's published in Med Hypotheses, I think "Well that's clearly b.s.". And I suspect that anyone who knows what Med Hypotheses is, which in my experience is most scientists above a certain pay-grade, gets the same reaction.

Now the problem is that yer average layman might well not know that Medical Hypotheses is a "special" journals. So AIDS denialists can cite papers published there as evidence and laypeople might find that convincing. But I'm not convinced that this is a real risk. I mean, AIDS denalists have lots of dirty tricks up their sleeves like quote mining, asking "awkward questions" that were answered 20 years ago, etc. How much extra harm are these papers going to do?

I suppose my ideal would be for Medical Hypotheses to continue as an Elsevier journal but only people with science degrees are allowed to read it or even know it exists... because I do think it serves a useful function within the scientific community.

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Welcome to Hawk/Handsaw...

This is the blog of Paul Wilson. You can find science- and pseudoscience-related things here, as well as occasional posts on my current research. There is also some stuff about what I do in my spare time (mostly cycling and complaining about politics).